Pub Date : 2023-01-01DOI: 10.32440/ar.2023.140.02.rev08
E. Pérez-Ramírez, I. Iglesias, J. Alvar, I. Casas
Avian influenza is one of the most devastating animal diseases. It has a huge economic and sanitary impact and, in some instances, it represents a great risk for public health. Since late 2020 we are experiencing the most severe avian influenza epidemic in history, caused by the highly pathogenic subtype H5N1, belonging to clade 2.3.4.4b. This strain is causing important modifications in the epidemiology of the virus that have never been observed before: (1) a widely extended geographical distribution that confers the character of a panzootic, (2) occurrence of outbreaks throughout the year, unlike the previous seasonal patterns in autumn and winter, (3) high mortality rates not only in poultry, but also in wild birds and (4) more frequent spillovers from birds to mammals. In order to prevent the transmission of the virus from wild birds to poultry, it is important to improve the biosecurity of poultry farms, establish active and passive virological surveillance programs, assess vaccination strategies for domestic birds and develop real-time alert systems that are able to predict periods and areas at high risk for disease introduction. Although avian influenza viruses have limited capacity to jump to humans, this risk should not be underestimated, especially in the current situation with extremely high viral circulation in animals. In Spain, the National Center for Microbiology closely monitors all human cases of influenza A that are negative for the H1 and H3 seasonal subtypes, especially in patients who have contact with animals. For the prevention and control of this zoonosis it is essential to establish an effective and stable collaboration between professionals of the animal health, public health and environmental sectors.
{"title":"Could avian influenza A(H5N1) cause a new pandemic?","authors":"E. Pérez-Ramírez, I. Iglesias, J. Alvar, I. Casas","doi":"10.32440/ar.2023.140.02.rev08","DOIUrl":"https://doi.org/10.32440/ar.2023.140.02.rev08","url":null,"abstract":"Avian influenza is one of the most devastating animal diseases. It has a huge economic and sanitary impact and, in some instances, it represents a great risk for public health. Since late 2020 we are experiencing the most severe avian influenza epidemic in history, caused by the highly pathogenic subtype H5N1, belonging to clade 2.3.4.4b. This strain is causing important modifications in the epidemiology of the virus that have never been observed before: (1) a widely extended geographical distribution that confers the character of a panzootic, (2) occurrence of outbreaks throughout the year, unlike the previous seasonal patterns in autumn and winter, (3) high mortality rates not only in poultry, but also in wild birds and (4) more frequent spillovers from birds to mammals. In order to prevent the transmission of the virus from wild birds to poultry, it is important to improve the biosecurity of poultry farms, establish active and passive virological surveillance programs, assess vaccination strategies for domestic birds and develop real-time alert systems that are able to predict periods and areas at high risk for disease introduction. Although avian influenza viruses have limited capacity to jump to humans, this risk should not be underestimated, especially in the current situation with extremely high viral circulation in animals. In Spain, the National Center for Microbiology closely monitors all human cases of influenza A that are negative for the H1 and H3 seasonal subtypes, especially in patients who have contact with animals. For the prevention and control of this zoonosis it is essential to establish an effective and stable collaboration between professionals of the animal health, public health and environmental sectors.","PeriodicalId":75487,"journal":{"name":"Anales de la Real Academia Nacional de Medicina","volume":"85 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135599707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.32440/ar.2022.139.03.rev03
J. A. Rodríguez Montes
Surgery is an action oriented medical specialty. Training excellent surgeons requires explicit and outcome predictable educational processes, so improve educational programmes in surgery are likely to represent better health for society. Given the extraordinary scientific-technical progress achieved, numerous surgical authorities suggest that the remarkable development of surgical research it needs its integrated in the classical teaching of Surgery. Specific, it is about determining if during the period of residence the postgraduate must investigate and if this activity is assumed and undertaken, know what to research, what kind of research you should do and for how long. How to integrate research training in the context of surgical learning is still a controversial topic; however, many countries promote integration of research training during the residence period, although they are important differences of opinion in the right paper and the structure of research in surgical training. For its objetives, philosophy that sustains it and positive effects on personal scientific education, it is concluded that it is convenient and necessary to incorporate surgical research in the training curriculum of surgeons.
{"title":"Should research be integrated in the trainig of the surgeon?","authors":"J. A. Rodríguez Montes","doi":"10.32440/ar.2022.139.03.rev03","DOIUrl":"https://doi.org/10.32440/ar.2022.139.03.rev03","url":null,"abstract":"Surgery is an action oriented medical specialty. Training excellent surgeons requires explicit and outcome predictable educational processes, so improve educational programmes in surgery are likely to represent better health for society. Given the extraordinary scientific-technical progress achieved, numerous surgical authorities suggest that the remarkable development of surgical research it needs its integrated in the classical teaching of Surgery. Specific, it is about determining if during the period of residence the postgraduate must investigate and if this activity is assumed and undertaken, know what to research, what kind of research you should do and for how long. How to integrate research training in the context of surgical learning is still a controversial topic; however, many countries promote integration of research training during the residence period, although they are important differences of opinion in the right paper and the structure of research in surgical training. For its objetives, philosophy that sustains it and positive effects on personal scientific education, it is concluded that it is convenient and necessary to incorporate surgical research in the training curriculum of surgeons.","PeriodicalId":75487,"journal":{"name":"Anales de la Real Academia Nacional de Medicina","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69672108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.32440/ar.2023.140.02.fdlm01
J.M. Ramírez Sebastián
Este año 2023 se celebra el cincuenta aniversario del ingreso en esta Real Academia Nacional de Medicina del Excmo. Sr. Dr. D. Ramón Castroviejo Briones como Académico de Honor de esta Institución y con ese motivo se ha puesto una pequeña exposición con los elementos más relevantes e ilustrativos que hacen referencia a dicho motivo y que han sido prestados gustosamente por el Instituto Castroviejo de la UCM.
{"title":"Ramón Castroviejo Briones. 50th anniversary of his admission to the Royal National Academy of Medicine","authors":"J.M. Ramírez Sebastián","doi":"10.32440/ar.2023.140.02.fdlm01","DOIUrl":"https://doi.org/10.32440/ar.2023.140.02.fdlm01","url":null,"abstract":"Este año 2023 se celebra el cincuenta aniversario del ingreso en esta Real Academia Nacional de Medicina del Excmo. Sr. Dr. D. Ramón Castroviejo Briones como Académico de Honor de esta Institución y con ese motivo se ha puesto una pequeña exposición con los elementos más relevantes e ilustrativos que hacen referencia a dicho motivo y que han sido prestados gustosamente por el Instituto Castroviejo de la UCM.","PeriodicalId":75487,"journal":{"name":"Anales de la Real Academia Nacional de Medicina","volume":"81 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135599708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-01DOI: 10.32440/ar.2022.139.02.rev04
M. Pozo, N. Hernández-Martín, P. Bascuñana, R. Fernández de la Rosa, F. Gomez, E. D. Martin, L. García-García
Epilepsy is a chronic neurological disease characterized by spontaneous recurrently occurring epileptic seizures as a consequence of abnormal, excessive and synchronous neuronal activity in the brain. Temporal lobe epilepsy (TLE) is the most common form of focal epilepsy in adults, being characterized by hippocampal sclerosis, reactive gliosis, neurodegeneration, and synaptic reorganization. Animal models of TLE based on the administration of convulsive agents trigger a status epilepticus (SE) that progresses towards the occurrence of spontaneous recurrent seizures. Among these models are those induced by the systemic administration of pilocarpine or by intrahippocampal injection of kainic acid, both being characterized by 3 clearly defined phases: (i) acute SE seizures; (ii) latent period and (iii) occurrence of recurrent spontaneous seizures. These models not only reproduce most of the neuropathological TLE features but also allow for the identification of biomarkers of epileptogenesis and potential pharmacological targets. The use of neuroimaging techniques such as positron emission tomography (PET) with the radiotracer 18F-Fluorodeoxyglucose (18F-FDG) identifies brain hypometabolism in the latent period that not only localizes the epileptic focus but is also an biomarker of early diagnosis. Other neuroimaging techniques allow for detecting, among others, biomarkers of neuroinflammation, alterations in the permeability of the blood-brain barrier and astrocytic activation, all of them associated with epileptogenesis. Finally, the use of chemogenetics through DREADDs (Designer Receptors Exclusively Activated by Designer Drugs) technology in murine models leads to targeted modulation of astrocytic activity, being a novel tool that considers the contribution of the astrocytes role in brain metabolic alterations in epileptogenesis.
{"title":"Experimental models in the study of epileptogenesis","authors":"M. Pozo, N. Hernández-Martín, P. Bascuñana, R. Fernández de la Rosa, F. Gomez, E. D. Martin, L. García-García","doi":"10.32440/ar.2022.139.02.rev04","DOIUrl":"https://doi.org/10.32440/ar.2022.139.02.rev04","url":null,"abstract":"Epilepsy is a chronic neurological disease characterized by spontaneous recurrently occurring epileptic seizures as a consequence of abnormal, excessive and synchronous neuronal activity in the brain. Temporal lobe epilepsy (TLE) is the most common form of focal epilepsy in adults, being characterized by hippocampal sclerosis, reactive gliosis, neurodegeneration, and synaptic reorganization. Animal models of TLE based on the administration of convulsive agents trigger a status epilepticus (SE) that progresses towards the occurrence of spontaneous recurrent seizures. Among these models are those induced by the systemic administration of pilocarpine or by intrahippocampal injection of kainic acid, both being characterized by 3 clearly defined phases: (i) acute SE seizures; (ii) latent period and (iii) occurrence of recurrent spontaneous seizures. These models not only reproduce most of the neuropathological TLE features but also allow for the identification of biomarkers of epileptogenesis and potential pharmacological targets. The use of neuroimaging techniques such as positron emission tomography (PET) with the radiotracer 18F-Fluorodeoxyglucose (18F-FDG) identifies brain hypometabolism in the latent period that not only localizes the epileptic focus but is also an biomarker of early diagnosis. Other neuroimaging techniques allow for detecting, among others, biomarkers of neuroinflammation, alterations in the permeability of the blood-brain barrier and astrocytic activation, all of them associated with epileptogenesis. Finally, the use of chemogenetics through DREADDs (Designer Receptors Exclusively Activated by Designer Drugs) technology in murine models leads to targeted modulation of astrocytic activity, being a novel tool that considers the contribution of the astrocytes role in brain metabolic alterations in epileptogenesis.","PeriodicalId":75487,"journal":{"name":"Anales de la Real Academia Nacional de Medicina","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42952255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-01DOI: 10.32440/ar.2022.139.02.rev01
A. C. Cruz Jentoft
Drugs are widely used to treat acute and chronic conditions in older people. However, the incidence of adverse drug reactions increases with age and are a frequent cause of hospital admission, especially in patients with multimorbidity and polypharmacy. Many of these adverse drug reactions could potentially be prevented. A prescription is considered to be potentially inappropriate in an older person if it carries a significant risk of producing an adverse drug reaction, especially when a safer alternative is available. In recent years, many instruments have been developed to help detecting potentially inappropriate prescriptions, most of them explicit lists of drugs that should not be used or cannot be used in the presence of certain conditions. The most widely used are the Beers-AGS criteria and the STOPP-START criteria. A systematic use of such instruments has been shown to improve not only the quality of prescriptions, but also several health outcomes in older multimorbid patients. Research is growing on the new concept of deprescription, described as the process of withdrawing inappropriate drugs, supervised by a health care professional, with the intention of reducing polypharmacy, improving outcomes and limiting iatrogenia. Prescriptors should become familiar with the different tools available to improve prescription quality and reduce drug related risks in older complex patients.
{"title":"Inappropriate drug prescription in older people","authors":"A. C. Cruz Jentoft","doi":"10.32440/ar.2022.139.02.rev01","DOIUrl":"https://doi.org/10.32440/ar.2022.139.02.rev01","url":null,"abstract":"Drugs are widely used to treat acute and chronic conditions in older people. However, the incidence of adverse drug reactions increases with age and are a frequent cause of hospital admission, especially in patients with multimorbidity and polypharmacy. Many of these adverse drug reactions could potentially be prevented. A prescription is considered to be potentially inappropriate in an older person if it carries a significant risk of producing an adverse drug reaction, especially when a safer alternative is available.\u0000In recent years, many instruments have been developed to help detecting potentially inappropriate prescriptions, most of them explicit lists of drugs that should not be used or cannot be used in the presence of certain conditions. The most widely used are the Beers-AGS criteria and the STOPP-START criteria. A systematic use of such instruments has been shown to improve not only the quality of prescriptions, but also several health outcomes in older multimorbid patients.\u0000Research is growing on the new concept of deprescription, described as the process of withdrawing inappropriate drugs, supervised by a health care professional, with the intention of reducing polypharmacy, improving outcomes and limiting iatrogenia. Prescriptors should become familiar with the different tools available to improve prescription quality and reduce drug related risks in older complex patients.","PeriodicalId":75487,"journal":{"name":"Anales de la Real Academia Nacional de Medicina","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42850605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-01DOI: 10.32440/ar.2022.139.02.org02
J. Pizones, F. Sánchez Pérez-Grueso, L. Moreno-Manzanaro, I. Obeid, F. Kleinstück, A. Alanay, F. Pellisé
Objective: Adult scoliosis (AS) is often associated with rotational thoracolumbar (TL) kyphosis. The impact of surgical correction on lumbar sagittal distribution, ideal sagittal plane matching, and mechanical complications is still underexplored. Methods: In this retrospective study, prospectively collected data were analyzed from a multicenter adult deformity database. Inclusion criteria were surgical patients with AS and TL/L curves > 30°, T10-L2 sagittal kyphosis (TLK) > 20°, and at least a 2-year follow-up. We analyzed preoperative and postoperative variables and studied the consequences of TL sagittal change on ideal type mismatch and on mechanical complications using univariate and multivariate logistic regression analyses, and compared patients with high pelvic incidence (PI > 50°) versus those with low PI (PI < 50°). Results: A total of 171 patients were included. The TLK segment flattened by a mean of 20° after surgery. The residual TLK kyphosis matched that expected by PI. The TL sagittal change was not directly associated with complications or ideal shape mismatch. Mechanical complications were associated only with older age and pelvic instrumentation. Patients with low and high PI were found to have similar Cobb angle correction, TLK correction, and rate of mechanical complications. However, it was more challenging to restore an ideal sagittal profile in patients with high PI and in patients fused to the pelvis. Conclusions: Surgical correction of adult TL scoliosis flattens the TL segment by about 20°, automatically adjusting to the ideal parameters dictated by patients’ PI. The TL segment change lengthens the upper lumbar arc by one segment, shifting the inflection point cranially. However, this change has no direct impact on mechanical complications or final sagittal shape matching.
{"title":"The Impact of Adult Scoliosis Surgical Correction on Thoracolumbar Rotational Kyphosis","authors":"J. Pizones, F. Sánchez Pérez-Grueso, L. Moreno-Manzanaro, I. Obeid, F. Kleinstück, A. Alanay, F. Pellisé","doi":"10.32440/ar.2022.139.02.org02","DOIUrl":"https://doi.org/10.32440/ar.2022.139.02.org02","url":null,"abstract":"Objective: Adult scoliosis (AS) is often associated with rotational thoracolumbar (TL) kyphosis. The impact of surgical correction on lumbar sagittal distribution, ideal sagittal plane matching, and mechanical complications is still underexplored.\u0000Methods: In this retrospective study, prospectively collected data were analyzed from a multicenter adult deformity database. Inclusion criteria were surgical patients with AS and TL/L curves > 30°, T10-L2 sagittal kyphosis (TLK) > 20°, and at least a 2-year follow-up. We analyzed preoperative and postoperative variables and studied the consequences of TL sagittal change on ideal type mismatch and on mechanical complications using univariate and multivariate logistic regression analyses, and compared patients with high pelvic incidence (PI > 50°) versus those with low PI (PI < 50°).\u0000Results: A total of 171 patients were included. The TLK segment flattened by a mean of 20° after surgery. The residual TLK kyphosis matched that expected by PI. The TL sagittal change was not directly associated with complications or ideal shape mismatch.\u0000Mechanical complications were associated only with older age and pelvic instrumentation. Patients with low and high PI were found to have similar Cobb angle correction, TLK correction, and rate of mechanical complications. However, it was more challenging to restore an ideal sagittal profile in patients with high PI and in patients fused to the pelvis.\u0000Conclusions: Surgical correction of adult TL scoliosis flattens the TL segment by about 20°, automatically adjusting to the ideal parameters dictated by patients’ PI. The TL segment change lengthens the upper lumbar arc by one segment, shifting the inflection point cranially. However, this change has no direct impact on mechanical complications or final sagittal shape matching.","PeriodicalId":75487,"journal":{"name":"Anales de la Real Academia Nacional de Medicina","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46682081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-01DOI: 10.32440/ar.2022.139.02.rev05
F. L. Lozano Sánchez
A review of the literature on aortic aneurysms is carried out, focusing on abdominal aortic aneurysms as the most frequent location. After introducing the topic (concept, frequency, natural history of the disease, consequences -mortality-, etc.), the review focuses on the individualized treatment of this entity and the improvements obtained during the last decade, both in elective and non-elective situations, which have led to a reduction in mortality. These improvements are due to several components such as: a) early diagnosis (screening effect) and correct follow-up of aneurysms (using echo-Doppler) that have made it possible to increase more elective surgeries and reduce urgent surgeries; b) control of cardiovascular risk factors, mainly tobacco and the use of statins in this type of patient; c) the role of endovascular surgery, which has made it possible to expand surgical indications to patients previously not eligible for open surgery, including nonagenarians and some centenarians; and d) to the effect of centralizing the most complex cases (the higher the volume, the better the results).
{"title":"Treatment of aneurysms of the abdominal aorta. Improvements and evidences","authors":"F. L. Lozano Sánchez","doi":"10.32440/ar.2022.139.02.rev05","DOIUrl":"https://doi.org/10.32440/ar.2022.139.02.rev05","url":null,"abstract":"A review of the literature on aortic aneurysms is carried out, focusing on abdominal aortic aneurysms as the most frequent location. After introducing the topic (concept, frequency, natural history of the disease, consequences -mortality-, etc.), the review focuses on the individualized treatment of this entity and the improvements obtained during the last decade, both in elective and non-elective situations, which have led to a reduction in mortality. These improvements are due to several components such as: a) early diagnosis (screening effect) and correct follow-up of aneurysms (using echo-Doppler) that have made it possible to increase more elective surgeries and reduce urgent surgeries; b) control of cardiovascular risk factors, mainly tobacco and the use of statins in this type of patient; c) the role of endovascular surgery, which has made it possible to expand surgical indications to patients previously not eligible for open surgery, including nonagenarians and some centenarians; and d) to the effect of centralizing the most complex cases (the higher the volume, the better the results).","PeriodicalId":75487,"journal":{"name":"Anales de la Real Academia Nacional de Medicina","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48669139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-01DOI: 10.32440/ar.2022.139.02.doc01
S. Delgado Pulido, J. I. Escrig-Larena, M. Mittelbrunn
Aging of the immune system is characterized by a progressive loss of function, which limits vaccine effectiveness and is responsible for the increase in the susceptibility to infections, cancer and autoimmune diseases observed in elderly population. Recent evidences suggest that intrinsic alterations accumulated in T lymphocytes with age actively contribute to the state of chronic inflammation which underlies age-associated pathologies. We have accelerated the aging process in mice by inducing a mitochondrial dysfunction exclusively in T cells. These mice showed signs of systemic premature senescence and multimorbidity, evidencing that alterations in T cell functionality are sufficient to accelerate a whole-organism aging phenotype. Thus, T cell aging plays a crucial role in systemic deterioration and may be involved in neurodegenerative, cardiovascular and metabolic diseases whose incidence drastically increases with age. Understanding how the immune system contributes to age-associated multimorbidity is an urgent challenge, which could lead to the development of new therapeutic strategies destined to achieve a healthier aging. In this regard, immunotherapy is emerging as a new and promising technique aimed to delay age-associated diseases.
{"title":"T cell senescence: A novel therapeutic target for aging","authors":"S. Delgado Pulido, J. I. Escrig-Larena, M. Mittelbrunn","doi":"10.32440/ar.2022.139.02.doc01","DOIUrl":"https://doi.org/10.32440/ar.2022.139.02.doc01","url":null,"abstract":"Aging of the immune system is characterized by a progressive loss of function, which limits vaccine effectiveness and is responsible for the increase in the susceptibility to infections, cancer and autoimmune diseases observed in elderly population. Recent evidences suggest that intrinsic alterations accumulated in T lymphocytes with age actively contribute to the state of chronic inflammation which underlies age-associated pathologies. We have accelerated the aging process in mice by inducing a mitochondrial dysfunction exclusively in T cells. These mice showed signs of systemic premature senescence and multimorbidity, evidencing that alterations in T cell functionality are sufficient to accelerate a whole-organism aging phenotype. Thus, T cell aging plays a crucial role in systemic deterioration and may be involved in neurodegenerative, cardiovascular and metabolic diseases whose incidence drastically increases with age. Understanding how the immune system contributes to age-associated multimorbidity is an urgent challenge, which could lead to the development of new therapeutic strategies destined to achieve a healthier aging. In this regard, immunotherapy is emerging as a new and promising technique aimed to delay age-associated diseases.","PeriodicalId":75487,"journal":{"name":"Anales de la Real Academia Nacional de Medicina","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48885030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-01DOI: 10.32440/ar.2022.139.02.rev03
J. A. Fernández-Tresguerres Hernández, L. Rancan, S. Paredes, E. Vara, M. Sánchez García
Melatonin is a hormone that acts facilitating the appearance of physiological sleep It has also a very evident antinflammatory and antioxidant capacities that result in beneficial actions on the aging processes in the cardiovascular system and in the lungs where our group has detected a protective action against oxidative stress , inflammation and apoptosis . Although melatonin is not viricidal by itself in some models of viral infections it has demonstrated its ability to reduce viral load and also inflammation and oxidation, reducing the severity of the disease. In COVID 19 melatonin has been shown to be able to interfere with the infectious process that takes place through ACE2 and EGF receptors being able to block these interactions thus reducing viremia .It is able to block the activation of the NLRP3 inflammasome thus dramatically reducing the massive secretion of cytokines and markedly reducing hyperinflammation and apoptosis leading to a better evolution of the disease .For all these reasons melatonin could play an important role in the treatment of COVID 19.
{"title":"Scientific basis for the use of melatonin in COVID 19","authors":"J. A. Fernández-Tresguerres Hernández, L. Rancan, S. Paredes, E. Vara, M. Sánchez García","doi":"10.32440/ar.2022.139.02.rev03","DOIUrl":"https://doi.org/10.32440/ar.2022.139.02.rev03","url":null,"abstract":"Melatonin is a hormone that acts facilitating the appearance of physiological sleep It has also a very evident antinflammatory and antioxidant capacities that result in beneficial actions on the aging processes in the cardiovascular system and in the lungs where our group has detected a protective action against oxidative stress , inflammation and apoptosis . Although melatonin is not viricidal by itself in some models of viral infections it has demonstrated its ability to reduce viral load and also inflammation and oxidation, reducing the severity of the disease. In COVID 19 melatonin has been shown to be able to interfere with the infectious process that takes place through ACE2 and EGF receptors being able to block these interactions thus reducing viremia .It is able to block the activation of the NLRP3 inflammasome thus dramatically reducing the massive secretion of cytokines and markedly reducing hyperinflammation and apoptosis leading to a better evolution of the disease .For all these reasons melatonin could play an important role in the treatment of COVID 19.","PeriodicalId":75487,"journal":{"name":"Anales de la Real Academia Nacional de Medicina","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47561304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-01DOI: 10.32440/ar.2022.139.02.ed01
J. Alvar Ezquerra, T. Beca
{"title":"From Jenner to monkeypox epidemic, 200 years of history brought to life","authors":"J. Alvar Ezquerra, T. Beca","doi":"10.32440/ar.2022.139.02.ed01","DOIUrl":"https://doi.org/10.32440/ar.2022.139.02.ed01","url":null,"abstract":"","PeriodicalId":75487,"journal":{"name":"Anales de la Real Academia Nacional de Medicina","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46779536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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